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Jerry Elliot Libbin - North Sea South Beach Music Festival 0o,4 Se= .5Ca.tt1. 1342- cL tut ri c__ F'�s-t,,►�►s r> RECEIVED MAY 0 5 2020 F r� CITY OF MIAMI BEACH bh OFFICE OF THE CI-TY CLERK ! Office of the City Clerk 1700 Convention Center Drive Miami Beach,FL 33139 305.873.7411 LOBBYIST REOISTRATION FORM Lobbyist means all persons employed or retained,whether paid or not,by a principal who seeks to encourage the passage,defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision,recommendation of the City Manager or any City board or committee;or any action,decision or recommendation of any City personnel during the time period of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the City Commission, or a City board or committee.The term specifically Includes the principal as well as any employee engaged in lobbying activities.The term°Lobbyist"has specific exclusions.Please refer to City Code Chapter 2,Article VII, Division 3.entitled"Lobbyists," for additional information. Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City Clerk. If you need more space to complete an answer, use a separate sheets)of paper. If you have nothing to report in a particular section, you must write "none" or "n/e" In that section. Any change to any information originally filed, ar any additional City Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form. The lobbyist has a continuing duty to supply Information and amend the forms filed throughout the period that the lobbying occurs Separate registration forms shall be required for each principal represented on each specific issue I. LOBBYIST INFORMATION: NAME OF LOBBYIST (Last) (First) (Middle Name) /7e)nee,' ,Y.4410 MiA17: .49/9.44 CA-4tide2 U.e 14,1-leRce birt " Lvia FL LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) ` (State) (Zip Code) U i— 7 --/Jo o =.�.�c1`v 7/O Tae n.�•n.d t!„�i��,,c LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS iI. PRINCIPAL INFORMATION: NAME OF PRINCIPAL (Last) ( imt) (Middle Name) Tev,'c4 Fvivad-rAv.f/ �o.� T-��TP.�SX � fir/%/eHJ3fi J CL,,eilc4c) / ''oX 8� PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Coda) �1-s 97)1/tiV t.�-F9yGo'z7 -Yz. 2et6deyRE/...1a ("I 7-8..c�r� PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS Pursuant to City Code Section 2-412(h)(1)(a):A principal of any corporation,partnership,or other entity who appears as a lobbyist on behalf of that entity,without special compensation or reimbursement for the appearance,whether direct,indirect or contingent.to express support of or opposition to an Item shall register with the Clerk as required by this subsection but shall not be required to Day anv reoistretinn rasp if the principal is a Corporation, Partnership or Trust, the following Information MUST be provided pursuant to City Code Section 2-482(c): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): 6/2 e,5 v e 0/-4..r • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A S%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(H none,write NIA): &oft-6 Page 1 of 6 r r 61,d • ,,vet.,1 6 A,,z&,4 JUL 082020 Ill. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where applicable of a pending request for proposal,invitation to bid,or public hearing number, /11Q2. 504-—Ca v f` tfe lch /Ivy• Fe1'i v"/ 11,4 N42ct Zo? J IV.CITY AGENCIESliNDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2.482(a)(4), list the City Commissioner or City personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid)with said City Commissioner or City personnel from 12 months preceding such commencement of service with the City to the present date,stating the general nature of the subject contractual relationship. Full Name of Individual and Contractual Relationship(If yes,explain) YES NO Title of Person to be Lobbied Co 7y 6A�,'1.`ff.`a Pursuant to City Code Section 2-482(g), every registrant shall be required to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety,with any current City Commissioner or City personnel who is sought.to be lobbied as identified on the lobbyist registration form filed. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write NIA): V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION —Be Specific. (Note that a contingency fee is prohibited pursuant to City Code SOC.2-486.3): fro4'E Page 2 of 6 The following six(6)questions MUST be answered: 1) Pursuant to City Code Section 2.488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": t • t .r ,. .i • ;I. . too.: f,uir tent or se o - :.n . pending award for aoede.equipment or service? 2) Pursuant to City Code Section 2.490,entitled`Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": Yea L4D: Are you lobbvina on a pendtna application fort Development Agreement with the City or application for chance of zoning map designation or change to the City's Future Land use Map? 3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of lobbyist" as set forth in Section 2.481)who only appears as a representative of a not-for-profit corporation or entity without special compensation or reimbursement for the appearance,whether direct or indirect to express support of or opposition to any item,shall register with the city clerk as required by this section,but shall not be required to pay any registration fees. Vcros_,No Ar© you rewraesenttna a not-for-pront corporation or entity without Spacial compensation or Folmbunaement? 4) Pursuant to City Code Section 2-481, the term"lobbyist"specifically excludes the following persons; Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct. indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or relbursement for the appearance. t/Yes_No: Are you providing only soientlflo. technical or other specialized information: Appearing' as a J'oDresentattvo of a neighborhood aesoolation without special compensation or reimbursement or tenrosontinp a not-for-pmt bggod organization for the purpose of reaueetina a grant without special compensation or LQimburooment? 5) Pursuant to City Code Section 2-401(1),no campaign consultant shall lobby the City Commission for a period of 12 months following the swearing in of any elected official(s)for wham the campaign consultant provided campaign consulting services within the past election cycle.See Section 2-491 for more information. _YesNa: Have you provided campaign consulting servtoea to an Incumbent member of the City Commisslog y Rhin the scat oleo 3gn ovate?If yes,please list the Incumbentmember(sl of_the Qit/Commission: Yee No: f eta t.,a •+A c' .r!A • ,t • t a a Os, • • -Vld. eau- consultine services was sworn in? 6) Pursuant to City Code Section 2-482(0)(4)a.,a lobbyist who has within the past election cycle provided campaign consulting services to an incumbent member of the City Commission(which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular sarvice bfore lobbvina the City Commission at a public meeting. ®Yes r_/No: Have you provided cemeatan eeneultina service, to an incumbent member of the City Commisefon within the past elsction_cvesle?If yes.piease Het the incumbent membo js)of the City Commission: Yes_No: Jf yes. were you promised or did you receiveggonomie consideration In a chanac t2r campalan coneuitina services? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: [ )Yos' J No Amount Paid$ j MCR Mie Date Feld Lobbyist Registration Farm received and verified by: Jfl3'J 54 . z F:\CLER\SAIL\n0ORM5\LOBBYIST FORMS\Lobbyl5t Registration Fenn Rcvivad 03-11-20 REO.dac Revised 03/11/2020 Page 3 of 6 4 r S VE. SIG ATTR U.MER OATH: ra i R Ora A OF I7.4 A' CH •-'V.,' /l ERIE 1 I+q .d Y T S Li.S It TO T`c OFF G&OF TRE iT CLE ,A, Ill a t;:41 le :PA r+ i _S tile_ Minelarlyal. �iL1i3:Yt."FrAe'A N 6�'dosti TGt Lrir�P� AT 1` I l 1'.•.. D fat 1.}'t2 s 't�tMytciTuRROROORtt' ILOATION1O '` �-•'fi�lmarrt� -a ,:t'tRrn FY�Rt i .c�. , :- - �F �,BrfDIS, tLF RPtr�Tf'p P�r�gn._ 04neturb of Lobbyist: _J1-4.-4.--., S:r ' osre,,,1/t.”—�-. • i 1 tib aiammr von?or affirm that silt of Ole foreyongt facto,Giaternants,find dicc4p.esas In(al;form oro atm arid cult-CIO. ani that I hr tro tzad or t9rt familiar tti•Flh iha prwas�clx oorlatami in Onager 2.Alt VII,ihtt rn 3,srdifeLai r ts'0; f Dm Marti Beach City Cud .,.d aft raportfm reg Itatnants. stq^oreo`LoPty151: O J O f "2° i Slant Are t of Principal: �aft.. rr Pato — 4, 9 ' 1. . ' . 1 4 iVII NOTARY:SIGNATURE AND SEAL: L EYiS'i': ARINcEPAL Set, lV L><�- S r r � ft,� Q c,-.)i— wuio of i �g/� yuL wally , pE`J ecurity or. S`iiam to Sar IFirntedl and eub eribed be/mama, 8:>,Cm to for armed]and subscri ied baf'tr roe, by means of Q phys cat presortce by toica taof 0 psrtsieal prosence or O o�noritit :lcil, • alt: csy a'..,, rP iQ th 1LR whilewhilennotarization, / 2bby 15 _¢Ir of al]_ Of KnAtE OF LC Yt& t{olAEOFPyt;4CFY'l. mquu reC ID �proe tzed IEA FORM RtaEiJTIFIt t TIt3t6 FORM OF I©I 1 1'f lnv y' Rsrcanplly le.srrr, Ncrzsa Ay iSnan cl®rtsiur of "f }? rfc 5igarthufaorNotary PRO, :fit?A - f:' /city',0-4, na ar arolmy yped,PrI to., n,.c„t: I !Foie ci Panty, `�-- ' ARrE HERD/MC:a PtIRlrii`ar J3Lyrttp6q (NOTARY S 1'ty�7o:0,-. 89cK►mtto•Gime e1 Frsld. (NOTARY i3CAC) GO l'Ir.10 Tlsp ton t 96b l5Y, F *COCA.E rls f Oct t-2n20 Eat ailr`an+_s who proaidta only s:J,ntifie,t5dndeur cr WNW aisaelntt titin,mntian or I lemIntairlym push mooting,,n-'par ort mita tir:If LRfrpas m✓0 rill/Ml.CriIiSIRT et a rrt„hisarhood earoJMllan vhtha n eta panaarrusl or rrorm W,icame,v tiv as, Lama-leo,',metro, Cit.Iaefn;Ct�sr in fa�[i orrr e I Ilan Prar Of r appnallbr.In went f reqs tnL a;[rant eta rl o,, $i ol er,I LIppe�rr:P9 a lvAte nlsyn ar tiro app ;a A a rcp.9r5z5tur ar rei:tger,.0,reerP Tqv .•{ ,e,L • moo` __`�1� Seen for legalization of the facsimile of the signature appearing on the preceding document of Mr. Gregory Edward Elias, LL.M., born on May 27th, 1953, by me, Cornelia Alfonsina Petronella Baaten, LL.M., a deputy civil law notary, residing in Curagao, legally deputizing for Johnny Ronald Edward Kleinmoedig, LL.M., a civil law notary, practicing in Curagao on this 29t" day of April, 2020. That the legalization of the signature of Mr. Gregory Edward Elias, LL.M. does not entail an opinion of the Undersigned as to the content of the preceding document. ,rc N, . r7 �; flj�is � 'ti•.�I , \../ CR/js MIAMI BEACH City of Miami 8oaeh,1700 Convention Center Drive,Miami Beach,Florida 33139,www.mtamibeachfl.gov Office of the City Cleric Rafael E.Granada,City Clerk CityClerk@lmiamibeachfl.gov Tel:305.673.7411,Fox:305.673.7254 NAME OF LOBBYIST: .-1-41./e-7 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or principal)who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). In addition to any other penalties that may be imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for Statements filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th of each year, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a signed Statement under oath listing all lobbyist expenditures, as well as compensation received,for the preceding calendar year with regard to the specific issue on which I have been engaged to lobby. 2) LOBBYIST WITHDRAWAL Once an issue I have registered to lobby has concluded or I am no longer lobbying on that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE I understand annual registration of all lobbyists shall be required for each 12-month period commencing October 1 of each year, and the fee for such annual registration shall be $500.00 pursuant to Section 2-482 of the Miami Beach City Code. Signa re of b yfst Date 4/7(. F ICLEENALLWFORMSu.088YIST FORMSVLobbyet Repiylraticn Fpm Hewed 03.11.20 REQdoc Page 6 of 6